Change is coming – whether you like it or not.
That’s the gist of HHS Secretary Alex Azar’s statement to a group of hospital executives. Azar is pushing for changes to pricing transparency and other factors affecting the cost of healthcare. Meanwhile, United Healthcare, responding to consumer outcry, will give back much of the cost savings they negotiated with drug companies via rebates. New advances give hope to bile duct cancer patients and more in this week’s Innovation Partners BioBlog.
In response to consumer frustration United Healthcare will return millions in drug savings to its members. These payments reflect discounts the insurer negotiated with drug companies. Benefits could range from a few dollars to greater returns, depending on the drugs, as not all drugs come with rebates.
HHS Secretary Alex Azar spoke to a group of hospital executives and warned them that change is coming, whether they like it or not. Azar and others in Congress seek to address the soaring costs of healthcare including hospital charges. The emphasis is on greater transparency of costs and charges, access to health records, and other changes.
Drug companies have raised prices on medications for many of the most vulnerable patients. This includes those with chronic conditions such as multiple sclerosis and life-threatening diseases. In response, insurance companies are pushing the payment burden more and more onto patients. The New York Times reports on the stories of real people affected by these burdens.
U.S. Senators Bill Cassidy, M.D. (R-LA), Michael Bennet (D-CO), Chuck Grassley (R-IA), Tom Carper (D-DE), Todd Young (R-IN), and Claire McCaskill (D-MO) are seeking feedback from the health care and patient communities as they develop legislation to improve price transparency in the health care market and lower costs. The senators are specifically seeking responses to a dozen questions ranging from regulatory barriers to big data to cash prices.
UnitedHealth Group, the nation’s largest health insurance company, says it’s paying nearly 60% of its reimbursements – or $64 billion – via value-based care models that are rapidly replacing fee-for-service medicine in the U.S. Value-based pay is tied to health outcomes, performance and quality of care of medical-care providers who contract with insurers via alternative payment vehicles like accountable care organizations (ACOs), a delivery system that rewards doctors and hospitals for working together to improve quality and rein in costs.
Hospitals in Massachusetts, especially those in rural areas, will see a 2.5 percent increase — or an additional $52,896,645 — in Medicare payments related to the changes in reimbursement for prescription drugs. The findings were released by Avalere Health, a nonpartisan Washington, D.C.-based firm that analyzes the impact of health policies.
A majority of oncology treatments granted accelerated approval over the last 25 years have gone on to demonstrate a clinical benefit, US Food and Drug Administration (FDA) officials stated in JAMA Oncology.However, 5% of those drugs were eventually withdrawn from the market. Drugmakers have not yet completed postmarketing requirements (PMRs) for 40% of those indications.
New Hsp90 inhibitor drugs are the new hope for those with bile duct cancer. Bile duct cancer is inoperable and incurable. Testing for MIR21, a small RNA molecule could help judge whether a patient’s cancer was likely to respond to Hsp90 inhibitors. This may lead to new treatments.
In the October issue of the Journal of Clinical Pathways, Gina Cook, BA, co founder and chief executive officer of Navigating Cancer, suggests that clinical pathways should include symptom management. A thoughtful look at cancer care and clinical pathways and how patient experience is missing from the current paradigm.